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Colorectal cancer: Difference between revisions
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'''Colorectal carcinoma''' (<abbr>CRC</abbr>) refers to all cancers that can affect the colon and rectum. Carcinomas in the colon are the most common malignancy in the <abbr>GI</abbr>-tract, accounting for 95% of all GI cancers. | '''Colorectal carcinoma''' (<abbr>CRC</abbr>) refers to all cancers that can affect the colon and rectum. Carcinomas in the colon are the most common malignancy in the <abbr>GI</abbr>-tract, accounting for 95% of all GI cancers. | ||
CRC is the third most common type of cancer, but it’s the second most common cause of cancer-related death. It accounts for 10% of the world’s cancers. It’s mostly a disease of elderly, affecting those in their 60s and 70s. >90% of colorectal cancers develop from adenomatous polyps of the colon. | CRC is the third most common type of cancer, but it’s the second most common cause of cancer-related death. It accounts for 10% of the world’s cancers. It’s mostly a disease of elderly, affecting those in their 60s and 70s. >90% of colorectal cancers develop from [[Colonic polyps|adenomatous polyps]] of the colon. | ||
Screening is important to reduce the incidence of CRC. In Europe, screening programs for CRC are in development or recently launched. Generally, people above 50/55 should be screened with [[colonoscopy]], or alternatively, with a [[faecal occult blood test]]. | Screening is important to reduce the incidence of CRC. In Europe, screening programs for CRC are in development or recently launched. Generally, people above 50/55 should be screened with [[colonoscopy]], or alternatively, with a [[faecal occult blood test]]. | ||
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== Treatment == | == Treatment == | ||
The gold standard treatment for <abbr>CRC</abbr> is radical surgery. Options include left or right hemicolectomy, sigmoid colectomy, or total or subtotal colectomy. This may be performed open, laparoscopically, robot-assisted, etc. At least 12 regional lymph nodes must be removed for proper surgical staging. | The gold standard treatment for <abbr>CRC</abbr> is radical surgery. Options include left or right hemicolectomy, sigmoid colectomy, or total or subtotal colectomy. This may be performed [[Laparotomy|open]], [[Laparoscopic surgery|laparoscopically]], robot-assisted, etc. At least 12 regional lymph nodes must be removed for proper surgical staging. | ||
Rectal cancer is treated with ''total mesorectal excision'' (TME) in most cases, or more modern techniques like ''transanal endoscopic microsurgery'' (TEM). | Rectal cancer is treated with ''total mesorectal excision'' (TME) in most cases, or more modern techniques like ''transanal endoscopic microsurgery'' (TEM). | ||
CRC is one of the few cancers in which M1 cancers can be cured, as surgical resection of liver and/or lung metastases may allow for cure. | CRC is one of the few cancers in which M1 cancers can be cured, as surgical resection of liver and/or lung metastases (metastasectomy) may allow for cure. | ||
Surgery may also be used palliatively, either by resection, bypass operation, stoma formation, or by stenting. | Surgery may also be used [[Palliative surgery|palliatively]], either by resection, bypass operation, stoma formation, or by stenting. | ||
== Screening == | == Screening == | ||
Screening is important to reduce the incidence of CRC, as most CRCs develop from adenomatous polyps which take years to develop into cancer. In Europe, screening programs for CRC are in development or recently launched. Generally, people above 50/55 should be screened with [[colonoscopy]], or alternatively, with a [[faecal occult blood test]]. | Screening is important to reduce the incidence of CRC, as most CRCs develop from adenomatous polyps which take years to develop into cancer. In Europe, screening programs for CRC are in development or recently launched. Generally, people above 50/55 should be screened with [[colonoscopy]], or alternatively, with a [[faecal occult blood test]]. | ||
[[Category:Gastroenterology]] | <noinclude>[[Category:Gastroenterology]] | ||
[[Category:Gastrointestinal surgery]] | [[Category:Gastrointestinal surgery]]</noinclude> | ||